Effects of ACEI/ARB or CCB use on atrial fibrillation in hypertensive patients following permanent pacemaker implantation

作者：Zhijie Liu, Ning Bian, Shaorong Wu, Yantao Cao, Yiting Su, Wenying Li, Hairui Li, Xianwu Lan, Can Jiang, Yi‐Ming Fan, Jun Guo, Dongdong Chen · 发表于：Frontiers in Cardiovascular Medicine · 年份：2023 · DOI：10.3389/fcvm.2023.1191539 · 被引用次数：1 · 研究领域：Atrial Fibrillation Management and Outcomes、Cardiac pacing and defibrillation studies、Potassium and Related Disorders

Aims Permanent pacemaker implantation (PPI) combined with hypertension leads to a higher risk of new-onset atrial fibrillation (NOAF) for patients. Hence, it is essential to study how to reduce this risk. Currently, the effects of the two common anti-hypertensive drugs, angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) and calcium channel blockers (CCB), on the risk of NOAF for such patients remain unknown. This study aimed to investigate this association. Methods This single-center retrospective study included hypertensive patients with PPI and without prior history of AF/atrial flutter, heart valve disease, hyperthyroidism, etc. Patients were classified into ACEI/ARB group and CCB group based on their exposure drug information. The primary outcome was NOAF events that occurred within 12 months after PPI. The secondary efficacy assessments were the changes from baseline to follow-up in blood pressure and transthoracic echocardiography (TTE) parameters. A multivariate logistic regression model was used to verify our aim. Results A total of 69 patients were finally included (51 on ACEI/ARB and 18 on CCB). Both univariate analysis [odds ratio (OR) 0.241, 95% confidence interval (CI) 0.078–0.745] and multivariate analysis (OR: 0.246, 95% CI: 0.077–0.792) demonstrated that ACEI/ARB were associated with a lower risk of NOAF compared to CCB. The mean reduction in left atrial diameter (LAD) from baseline was greater in ACEI/ARB group than in CCB gro...